Ahmed Alsaieek, MD. MSc Consultant Cardiologist King Abdulaziz Cardiac Center National Guard - Riyadh Co-investigators: Mouaz Al-Mallah, Mohsen Alharthi, Ali Alghamdi, Mohammed Balgaith,
• TAVI is an alternative to surgical valve replacement in high risk patients with severe symptomatic aortic stenosis. • Because of advanced age at presentation, these patients are at high risk of associated CAD. • Cardiac CTA is the most widely used imaging modality to assess the aortic root, aorta and the iliofemoral access. • CTA has not been used as a sole test to assess coronary artery disease in these patients; the perceived technical challenges preclude routine clinical use.
Leon. N Engl J Med. Oct 21 2010;363(17):1597-1607. Smith N Engl J Med. Jun 9 2011;364(23):2187-2198.
• 75 y/o male • BMI=27.6 • Average HR=58 bpm
• 81 y/o female • BMI=27.6 • Average HR=94 bpm
Characteristics Age, years, mean+SD Male, n (%) BMI, mean+SD HR, bpm, mean+SD
n=32 74.7+5.9 22 (68.8%) 29.3+7.1 6612+
Sinus Rhythm, (%)
28 (88%)
CABG, n (%)
7 (21.9%)
Not assessable
8 (25%)
LAD, n (%)
3 (9.4%)
RCA, n (%)
8 (25%)
LCX, n (%)
3 (9.4%)
All, n (%)
1 (3.1%)
Assessable, n (%) Obstructive CAD (>50%)
comments
24 (75%) 16/24 (66.7%)
All grafts were assessable
Characteristics Age, years, mean+SD
Assessable Not Assessable n=24 n=8
p
74.3+6.1
75.6+5.6
ns
19 (79.2%)
3 (37.5%)
0.04
BMI, mean+SD
28.4+6.1
31.8+9.9
ns
HR, bpm, mean+SD
64.810.5+
79.39.3+
0.002
Sinus Rhythm (%)
21 (87.5%)
7 (87.5%)
ns
Grafts, n (%)
7 (100%)
0
-
AF or HR >65 bpm
12 (50%)
8 (100%)
0.014
Male, n (%)